Complaint: Vulvar pain lasting at least 3 months duration without a clear identifiable cause. Yep, that is vulvodynia. Last month’s post reviewed diagnosis; this month our post continues with options for treating the condition. Noor Dasouki Abu-Alnadi, MD, MS, who specializes in chronic pain syndromes such as vulvodynia, presented a 1-hour master class on the topic at the recent Contraceptive Technology conference, and shared how she helps when sex hurts because of vulvodynia. “Keep these initial treatments in your wheelhouse,” she said, because you will make use of them repeatedly.
Pain! Raw, burning, scratchy, sharp, stabbing—down there! And the suffering has gone on for a few months. The patient may complain of pain with sex (and pain with sex is simply not normal), pain when using tampons, or with wearing certain types of clothing. You examine her vulva and see…nothing unusual. No sign of infection, trauma, hormonal deficiency, neoplasm, or anything suggesting a neurologic or inflammatory condition. It is hard to help, unless you can diagnose. However, your patient has given you enough clues to help guide you.
While psychotic disorders like schizophrenia, bipolar disorder, and borderline personality disorder occur less commonly among reproductive-aged women than do mood and anxiety disorders, these serious mental illnesses (SMIs) have important implications for patients’ family planning. Providers need to recognize and appropriately manage unique ethical considerations in addition to assessing whether the patient may successfully use any given contraceptive method due to cognitive/behavioral issues and to potential interactions between contraceptive methods and psychiatric or other drugs.
Now available in a new 21st edition, this well-known text with more than 2 million copies in print has been the leading family planning resource... Read more
SAVE THE DATE
for September 22-24, 2021. Check back here to learn more as we develop the agenda, or sign up for our free monthly update.